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Contact Information

BENSON ORAL SURGERY AND DENTAL IMPLANTS, LLC
8809 W 400 N
SUITE 2
MICHIGAN CITY, IN46360-9330
 Phone: 219-879-8710
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral and Maxillofacial Surgery

261QS0112X
Indicates primary specialty

NPI Profile & details for BENSON ORAL SURGERY AND DENTAL IMPLANTS, LLC

NPI # 1740548015
LBN Legal business name BENSON ORAL SURGERY AND DENTAL IMPLANTS, LLC
Authorized official GREGORY BENSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/24/2012
Last updated 04/24/2012 - About 14 years ago
Identifiers
IN License # 12011706A
IN Medicaid 201031920A
WI Medicaid 33791200
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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